I hope you have enjoyed our blog posts on various health, nutritional and injury related topics. Please don't hesitate in calling us or myself if you have questions when the need to seek care arises. Call the office or myself. Office 915-850-0900 - Cell 915-540-8444 Great Regards. Dr. J

Concussions & Post-Concussion Syndrome

Concussions are traumatic brain injuries that affect brain function. Effects from these injuries are often temporary but can include headaches, problems with concentration, memory, balance and coordination. Concussions are usually caused by a blow to the head or violent shaking of the head and upper body. Some concussions cause loss of consciousness, but most do not. And it is possible to have a concussion and not realize it. Concussions are common in contact sports, such as football. However, most people gain a full recovery after a concussion.

Common Symptoms Of Concussion

Blurred eyesight or other vision problems, such as dilated or uneven pupils

Confusion

Dizziness

Ringing in the ears

Nausea or vomiting

Slurred speech

Delayed response to questions

Memory loss

Fatigue

Trouble concentrating

Continued or persistent memory loss

Irritability and other personality changes

Sensitivity to light and noise

Sleep problems

Mood swings, stress, anxiety or depression

Disorders of taste and smell

Mental/Behavioral Changes

Verbal outbursts

Physical outbursts

Poor judgment

Impulsive behavior

Negativity

Intolerance

Apathy

Egocentricity

Rigidity and inflexibility

Risky behavior

Lack of empathy

Lack of motivation or initiative

Depression or anxiety

Symptoms In Children

Concussions can present differently in children

Excessive crying

Loss of appetite

Loss of interest in favorite toys or activities

Sleep issues

Vomiting

Irritability

Unsteadiness while standing

Amnesia

Memory loss and failure to form new memories

Retrograde Amnesia

Inability to remember things that happened before the injury

Due to failure in recall

Anterograde Amnesia

Inability to remember things that happened after the injury

Due to failure to formulate new memories

Even short memory losses can be predictive of outcome

Amnesia may be up to 4-10 times more predictive of symptoms and cognitive deficits following concussion than is LOC (less than 1 minute)

Return To Play Progression

Baseline: No Symptoms

As the baseline step of the Return to Play Progression, the athlete needs to have completed physical and cognitive rest and not be experiencing concussion symptoms for a minimum of 48 hours. Keep in mind, the younger the athlete, the more conservative the treatment.

Step 3: Heavy, non-contact activity

The Goal: More intense but non-contact

The Time: Close to typical routine

The Activities: Running, high-intensity stationary biking, the player’s regular weightlifting routine, and non- contact sport-specific drills. This stage may add some cognitive component to practice in addition to the aerobic and movement components introduced in Steps 1 and 2.

Step 4: Practice & full contact

The Goal: Reintegrate in full contact practice.

Step 5: Competition

The Goal: Return to competition.

Microglial Priming

After head trauma microglial cells are primed and can become over active

To combat this, you must mediate the inflammation cascade

Prevent repeated head trauma

Due to priming of the foam cells, response to follow-up trauma may be far more severe and damaging

What Is Post-Concussion Syndrome (PCS)?

Symptoms following head trauma or mild traumatic brain injury, that can last weeks, months or years after injury

Symptoms persist longer than expected after initial concussion

More common in women and persons of advanced age who suffer head trauma

Severity of PCS often does not correlate to severity of head injury

PCS Symptoms

Headaches

Dizziness

Fatigue

Irritability

Anxiety

Insomnia

Loss of concentration and memory

Ringing in the ears

Blurry vision

Noise and light sensitivity

Rarely, decreases in taste and smell

Concussion Associated Risk Factors

Early symptoms of headache after injury

Mental changes such as amnesia or fogginess

Fatigue

Prior history of headaches

Evaluation Of PCS

PCS is a diagnosis of exclusion

If patient presents with symptoms after head injury, and other possible causes have been ruled out => PCS

Use appropriate testing and imaging studies to rule out other causes of symptoms

Headaches In PCS

Often “tension” type headache

Treat as you would for tension headache

Reduce stress

Improve stress coping skills

MSK treatment of the cervical and thoracic regions

Constitutional hydrotherapy

Adrenal supportive/adaptogenic herbs

Can be migraine, especially in people who had pre-existing migraine conditions prior to injury

Reduce inflammatory load

Consider management with supplements and or medications

Reduce light and sound exposure if there is sensitivity

Dizziness In PCS

After head trauma, always assess for BPPV, as this is the most common type of vertigo after trauma

Dix-Hallpike maneuver to diagnose

Epley’s maneuver for treatment

Light & Sound Sensitivity

Hypersensitivity to light and sound is common in PCS and typically exacerbates other symptoms such as headache and anxiety

Management of excess mesencephalon stimulation is crucial in such cases

Sunglasses

Other light blocking glasses

Earplugs

Cotton in ears

Treatment Of PCS

Manage each symptom individually as you otherwise would

Manage CNS inflammation

Curcumin

Boswelia

Fish oil/Omega-3s – (***after r/o bleed)

Cognitive behavioral therapy

Mindfulness & relaxation training

Acupuncture

Brain balancing physical therapy exercises

Refer for psychological evaluation/treatment

Refer to mTBI specialist

mTBI Specialists

mTBI is difficult to treat and is an entire specialty both in the allopathic and complementary medicine

Primary objective is to recognize and refer for appropriate care

Pursue training in mTBI or plan to refer to TBI specialists

Sources

“A Head for the Future.” DVBIC, 4 Apr. 2017, dvbic.dcoe.mil/aheadforthefuture.

As an extension to effective rehabilitation, we too offer our patients, disabled veterans, athletes, young and elder a diverse portfolio of strength equipment, high-performance exercises and advanced agility treatment options. We have teamed up with the cities premier doctors, therapist and trainers to provide high-level competitive athletes the possibilities to push themselves to their highest abilities within our facilities.

We’ve been blessed to use our methods with thousands of El Pasoans over the last three decades allowing us to restore our patients’ health and fitness while implementing researched non-surgical methods and functional wellness programs.

Our programs are natural and use the body’s ability to achieve specific measured goals, rather than introducing harmful chemicals, controversial hormone replacement, un-wanted surgeries, or addictive drugs. We want you to live a functional life that is fulfilled with more energy, a positive attitude, better sleep, and less pain. Our goal is to ultimately empower our patients to maintain the healthiest way of living.

With a bit of work, we can achieve optimal health together, no matter the age or disability.

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As an extension to effective rehabilitation, we too offer our patients, disabled veterans, athletes, young and elder a diverse portfolio of strength equipment, high-performance exercises and advanced agility treatment options. We have teamed up with the cities premier doctors, therapist and trainers to provide high-level competitive athletes the possibilities to push themselves to their highest abilities within our facilities.

We’ve been blessed to use our methods with thousands of El Pasoans over the last three decades allowing us to restore our patients’ health and fitness while implementing researched non-surgical methods and functional wellness programs.

Our programs are natural and use the body’s ability to achieve specific measured goals, rather than introducing harmful chemicals, controversial hormone replacement, un-wanted surgeries, or addictive drugs. We want you to live a functional life that is fulfilled with more energy, a positive attitude, better sleep, and less pain. Our goal is to ultimately empower our patients to maintain the healthiest way of living.

With a bit of work, we can achieve optimal health together, no matter the age or disability.